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You are here: Home / 12. Environmental / Heat Illness

Heat Illness

July 14, 2011 by CrashMaster

 

 

 

Heat Loss:

Radiation-loss to ambient air

Convection-air currents

Conduction-direct contact with cooler object

Evaporation-sweating

 

Heat loss is reduced by phenothiazines, anticholinergics, B-Blockers, Ca-Blockers, Diuretics, Amphetamines, LSD, Cocaine, MAO Inhibitors

 

Heat Cramps

hyponatremia leading to muscle cramping, usually the calves, thighs, and shoulders.

 

Heat Tetany

hyperventilation leading to respiratory alkalosis

 

Heat Exhaustion

salt depletion from sweating, leads to hypovolemia and hypoperfusion.  Patient will retain normal mental status and neurologic exam.  Temperature may only be slightly elevated.  The patient will look spent.

 

Heat Stroke

Need CNS dysfunction and Temp>40

Breakdown of central thermoregulatory control

Hyperpyrexia, altered mental status, neurologic findings, and possibly the absence of sweating

Can lead to NCPE, ARDS, LFT elevations, ATN, Hematuria, Rhabdomyolysis, DIC

Immediate, aggressive cooling down to <39° C using ice packs in groin and axilla, spray the patient continuously with water, place in front of fan.

 

Fluid loss is usually not large.  Give 2 L of NS and then cut back to ~500 cc/hr.

ABG c Lactate, CBC, Lytes, LFTs, PT/PTT, UA and Myoglobin.

Shivering can be controlled with benzos or meperidine.

Antipyretics are not effective.

 

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Filed Under: 12. Environmental


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